Abstract
Diseases of the upper gastrointestinal tract have become more prevalent over time. Mechanisms of disease formation are still only partially understood. Recent literature has shown that the surrounding microbiome affects the propensity for disease formation in various parts of the upper gastrointestinal tract. A review was performed of any literature to our best knowledge concerning the effects of pharmacologic agents, environmental changes, and surgical intervention on the microbiome of the upper gastrointestinal tract. Searches of the literature were performed using specific keywords related to drugs, surgical procedures, and environmental factors. Many prescription and nonprescription drugs that are commonly used have varying effects on the upper gastrointestinal tract. Proton pump inhibitors may affect the relative prevalence of some organisms in the lower esophagus and have less effect in the proximal esophagus. Changes in the esophageal microbiome correlate with some esophageal diseases. Drugs that induce weight loss have also been shown to affect the microbiomes of the esophagus and stomach. Common surgical procedures are associated with shifts in the microbial community in the gastrointestinal tract. Environmental factors have been shown to affect the microbiome in the upper gastrointestinal tract, as geographic differences correlate with alterations in the microbiome of the gastrointestinal tract. Understanding the association of environmental and pharmacologic changes on the microbiome of the upper gastrointestinal tract will facilitate treatment plans to reduce morbidity from disease.
Highlights
The human microbiome contains trillions of microorganisms, many of which are bacteria that assist the host by aiding in the digestion of nutrients and playing a vital role in the innate and adaptive immune system of the host [1]
A review of the literature concerning the upper gastrointestinal tract shows that environmental differences, pharmacologic changes, and specific surgeries can affect the microbiome, which can lead to disease
Fecal microbiota transplantation is an important aspect of the treatment of some diseases of the gastrointestinal tract, it was omitted from this discussion of the upper gastrointestinal tract microbiome
Summary
The human microbiome contains trillions of microorganisms, many of which are bacteria that assist the host by aiding in the digestion of nutrients and playing a vital role in the innate and adaptive immune system of the host [1]. Alteration of the microbiome, plays an important role in chronic inflammation, dysplasia, cancers, and other esophageal diseases [2,3]. The gastrointestinal tract has an important relationship with the microbial community within its lumen. Most literature has focused on the microbiome of the lower gastrointestinal tract and its association with disease, the microbiome of the upper gastrointestinal tract is increasingly being studied [4,5,6]. A review of the literature concerning the upper gastrointestinal tract shows that environmental differences, pharmacologic changes, and specific surgeries can affect the microbiome, which can lead to disease. Our goals are to detail the association of environmental and pharmacologic changes on the upper gastrointestinal microbiome and how those changes may increase the risk of disease
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